Health Crisis, Excruciating Pains of Arthritis

Every person living with arthritis, irrespective of their age, experiences pains in joints, waist, shoulder, wrists, leg and knees.

The excruciating pains associated with health condition like arthritis, is a serious health crisis and it is affecting more than 350 million people globally.

Also, it is a leading cause of disability with the physical, emotional and economic impacts.

According to the Centre for Disease Control and Prevention, Arthritis is the inflammation or swelling of one or more joints.

"It can cause pain, stiffness and inflammation, making it difficult to move or stay active. It describes more than 100 conditions that affect the joints, tissues around the joint and other connective tissues.

"Arthritis is most common in the feet, hands, hips, knees and lower back areas of the body.

The various arthritis include: Osteoarthritis, Rheumatoid Arthritis, Gouty Arthritis, Ankylosing Spondylitis, Juvenile Idiopathic Arthritis, Vertebral Spondylosis, and Psoriatic Arthritis, among others."

The Global Rheumatoid Arthritis Network says, "Arthritis affects people of all ages, races, both genders – but more women develop it than men – and from babies to older people."

Moreover, the global burden of arthritis is expected to have significant consequences in terms of healthcare costs and loss of productivity by patients today and over the next 30 years.

Contrary to popular belief, arthritis is not a disease of the elderly, as more than three in five people diagnosed with arthritis, are under the age of 65.

Data from the Nigerian Orthopaedic Association shows that more than 1.5 million Nigerians suffer from arthritis annually.

Confirming this, the President of the association, Dr Kunle Olawepo, says arthritis is a global phenomenon with debilitating complications, saying prevention is the watchword.

Olawepo identifies the risk factors to developing arthritis as family history, age, gender, previous injury to the joint, smoking, overweight and obesity.

According to him, raising awareness about the importance of adopting a healthy lifestyle, encouraging early detection of arthritis, lifestyle modification by individuals and government's intervention, through the provision of medical aid to support treatment, will assist in proper management of the disease.

To diagnose arthritis, physicians conduct series of physical examination to detect symptoms, run blood tests to determine the type of arthritis and X-rays can diagnose osteoarthritis and check for abnormalities like bone spurs.

A new study found that the number of osteoarthritis cases has doubled in 29 years and is now a global public health concern.

Osteoarthritis is a chronic joint disease that causes pain, disability and loss of function.

The study "Prevalence Trends of Site-Specific Osteoarthritis From 1990 to 2019: Findings From the Global Burden of Disease Study 2019" published in Arthritis & Rheumatology report discovered that the number of osteoarthritis cases increased from 247.51 million in 1990 to 527.81 million in 2019.

"This is more than double the number of cases," the Report said, emphasising that the burden of osteoarthritis needs urgent attention and prevention measures to be put in place.

Similarly, a study on "Juvenile Idiopathic Arthritis in a New Rheumatology Clinic in Nigeria" published in the Journal of Advanced Rheumatology Science, showed that scarcity of Paediatric Rheumatologists in Africa was a challenge for the early detection and appropriate management of childhood-onset rheumatic diseases.

The study describes Juvenile Idiopathic Arthritis as the most common type of arthritis in children under the age of 16. "It can cause persistent joint pain, swelling and stiffness; and can affect one joint or many.

It noted that there are no Paediatric Rheumatologists in Nigeria, as suspected and confirmed cases of paediatric rheumatic diseases are managed by other paediatricians and adult-patient rheumatologists.

The study added that the awareness and indices of suspicion for paediatric rheumatic diseases was very low among Nigerian clinicians.

"It is unknown, how large the annual number of missed paediatric rheumatic diseases is and what burden this might be contributing to the morbidity and mortality due to childhood non-communicable diseases," it said.

Recently, Pfizer Biopharmaceutical hosted a Rheumatology Media Roundtable highlighting rheumatology disease burden in Nigeria and the importance of raising awareness, as well as enlightening the public about the management of rheumatoid arthritis to prevent disease progression.

According to the World Health Organisation (WHO), globally, about 14 million people have rheumatoid arthritis.

"Rheumatoid arthritis is a systemic autoimmune disease characterised by chronic inflammation of the joints."

A Rheumatologist, Dr Uyiekpan Ima-Edomwonyi of Lagos University Teaching Hospital (LUTH), Idi-Araba, said an increase in rheumatoid arthritis occurrence could stress medical services that are already struggling with a high burden of acute infectious diseases.

He said that they might be unable to cope with the fast changing patterns of disease distribution seen in Africa.

Ima-Edomwonyi says healthcare professionals, general physicians and rheumatologists need to identify rheumatoid arthritis early and begin appropriate therapy as soon as possible.

To, Dr Kodjo Soroh, the Country Medical Director, Pfizer East and West Africa, rheumatoid arthritis remains one of the most common rheumatic and musculoskeletal diseases (RMDs) in the region.

Soroh, however, raises hope as Pfizer aims to continue raising awareness around the treatments available, saying that the company was working closely with the healthcare community to ensure early diagnosis, increased patients' access and medication adherence.

"There is Project Afya, a patient assistance programme, aimed at improving access to life-saving medications and boosting cancer care and autoimmune disease management.

"In partnership with IQVIA, the platform is helping to reduce therapy costs for eligible patients as rheumatologists identify patients for enrolment into the programme," he said.

IQVIA, an American company, is a global provider of advanced analytics, technology solutions, and contract research services to the life science industry dedicated to creating intelligent connections that deliver unique innovations and actionable insights.

Another Rheumatologist, Dr Hakeem Olaosebikan, who works at the Lagos State University Teaching Hospital (LASUTH), Ikeja, said adequate treatment was critical to prevent or lessen the severity of comorbidities, particularly cardiovascular disease, which was still a major cause of mortality in rheumatoid arthritis patients.

Olaosebikan, who claimed that there is no known cure for arthritis, however, said that advances in science were assisting in identifying ways to improve diagnosis and treatment.

According to him, diets have huge role to play in the management of arthritis.

On what could be done, he said: "An increase intake of fruits, vegetables and fibres, reduce or stop salt, seasoning, sugar, alcohol and smoking, increase water, tumeric and Omega H3 intake can lower arthritis pain.

"Painkillers are not arthritis drugs, but are used to temporarily relieve pain; they are not for treating specific causes of arthritis."

Olaosebikan warned the public to avoid indiscriminate use of painkillers.

He, also suggested regular exercise to help keep muscles strong and joints limber as part of the measures to lower an individual's risk of arthritis, adding that maintaining healthy body weight, stretching regularly and getting routine checkups could help to ensure joints are staying healthy.

Olaosebikan said that late presentation to the hospital leading to delayed diagnosis, self medications, seeking alternative medical or traditional medicine, rather than rheumatologist, were some of the challenges confronting arthritis management in Nigeria.

He added that some arthritis tests and drugs were not readily accessible and affordable, saying most patients could not afford the treatment and investigations due to lack of universal health insurance coverage.

The expert called for provision of adequate health insurance to ameliorate the high cost of medical investigations and treatment.

By Oluwafunke Ishola